Three countries — the United States, Brazil, and Mexico — account for nearly half (46%) of the world’s reported COVID-19 deaths, yet they contain only 8.6% of the world’s population. Some 60% of Europe’s deaths are concentrated in just three countries — Italy, Spain, and the United Kingdom — which account for 38% of Europe’s population. There were many fewer deaths and lower death rates in most of Northern and Central Europe.

Several factors determine a country’s COVID-19 death rate: the quality of political leadership, the coherence of the government’s response, the availability of hospital beds, the extent of international travel, and the population’s age structure. Yet one deep structural characteristic seems to be shaping the role of these factors: countries’ income and wealth distribution.

High inequality undermines social cohesion, erodes public trust, and deepens political polarization, all of which negatively affect governments’ ability and readiness to respond to crises. This explains why the United States, Brazil, and Mexico account for nearly half of the world’s reported deaths since the start of the pandemic.

The U.S., Brazil, and Mexico have very high income and wealth inequality. The World Bank reports the respective Gini coefficients for recent years (2016-18) at 41.4 in the U.S., 53.5 in Brazil, and 45.9 in Mexico. (On a 100-point scale, a value of 100 signifies absolute inequality, with one person controlling all income or wealth, and zero means a completely equal distribution per person or household).

The U.S. has the highest Gini coefficient among the advanced economies, while Brazil and Mexico are among the world’s most unequal countries. In Europe, Italy, Spain, and the U.K. — with Gini scores of 35.6, 35.3, and 34.8, respectively — are more unequal than their Northern and Eastern counterparts, such as Finland (27.3), Norway (28.5), Denmark (28.5), Austria (30.3), Poland (30.5), and Hungary (30.5).

The correlation of death rates per million and income inequality is far from perfect; other factors matter a lot.

The U.S. is so unequal, politically divided, and badly governed under Trump that it has actually given up on any coherent national strategy to control the outbreak.

France’s inequality is on par with Germany’s, but its COVID-19 death rate is significantly higher. The death rate in relatively egalitarian Sweden is significantly higher than in its neighbors, because Sweden decided to keep its social distancing policies voluntary rather than mandatory. Relatively egalitarian Belgium was battered with very high reported death rates, owing partly to the authorities’ decision to report probable as well as confirmed COVID-19 deaths.

High income inequality is a social scourge in many ways. As Kate Pickett and Richard Wilkinson convincingly reported in two important books, “The Spirit Level” and “The Inner Level,” higher inequality leads to worse overall health conditions, which significantly increases vulnerability to COVID-19 deaths.

Moreover, higher inequality leads to lower social cohesion, less social trust, and more political polarization, all of which negatively affect governments’ ability and readiness to adopt strong control measures. Higher inequality means a larger proportion of low-income workers — from cleaners, cashiers, guards, and delivery persons to sanitation, construction, and factory workers — must continue their daily lives, even at the risk of infection. More inequality also means more people living in crowded living conditions and therefore unable to shelter safely.

The politics of resentment is almost the opposite of the politics of epidemic control.

Populist leaders exacerbate the enormous costs of inequality.

Read the rest of Jeffrey D. Sachs’ article here at MarketWatch